Introduction

Oh wow, I’m alive. That was the first thought I had when I woke up from the Nuss surgery. Waking up, I see my surgeon with a grin across his face. He was happy with the outcome of the surgery while I was going in and out of consciousness due to the lingering effects of the anesthesia.

What is the Nuss procedure?

The Nuss procedure is a minimally invasive surgical technique used to correct pectus excavatum, a congenital chest wall deformity where the breastbone (sternum) is sunken into the chest. During the procedure, the surgeon makes small incisions on either side of the chest and inserts a curved metal bar underneath the sternum. This bar is then rotated 180 degrees, pushing the sternum outward into a normal position. The bar remains in place for 2-3 years while the chest wall remodels, after which it is surgically removed. To prevent any graphic sights, I will not add any images.

My Case

As with every good thing, there is an index created to rate the severity of the deformity called the Haller Index. Unlike IMDB ratings, higher is not good. For all cases, a Haller index of 3.5 and above is considered severe enough for surgery.

In order to figure out my Haller index, I went to get an MRI. Right before entering the hospital to see the MRI results, my mom was like, “ohhh you won’t have a high Haller index.” I was like, “yeah, I don’t know about that…probably going to be a 7 or 8..” Spoilers, we were both way off :)

My Haller Index was 15.5, which caused my heart to be displaced to the left.

My Decision Process

Deciding on a major surgery is not a one-day process, or even a one-month process. It took a solid year or two for me to figure out whether I wanted this life-changing surgery. In the beginning, I was pretty against the surgery…this deformity is not hurting me, I do not need it…I will be in pain for three years for no reason. So, what changed? The MRI. The MRI was pretty eye-opening, I must say. Seeing your heart displaced to the left is pretty eye-opening. After my parents and I saw the MRI, my surgeon was wondering about my thoughts.

…

Yeah, I didn’t know. I think my surgeon knew that and figured that out based on my reaction. His idea? Let’s get a date in mind for when the surgery could be. Then, I will have five months to decide whether I really want the surgery, which was very useful in hindsight. So, do I have a flow chart or AI model to figure out whether you need surgery? Nah. It is something you need to talk out with your family, research the procedure yourself, read posts on the subreddit, and if you are comfortable, you can join the discord. The Reddit and Discord are both surprisingly useful.

The Disconnect

You might wonder why I am saying “surprisingly useful”…if you are not wondering, you can skip this section :) … just kidding. Pectus is one of those conditions that does not affect everyone in the same ways. With me, I did not know all the ways it affected me and still do not, even 3 months post-op. My parents had a better clue, but it was never clear or confirmed. Furthermore, there are always questions in your head that no doctor, parent, or friend can answer unless they have been through it. That is where the disconnect happens. A third party can always say something and try to put themselves in your shoes, but it almost never feels the same. Thus, the disconnect between patients and supporting cast.

When I joined the discord, I asked different users questions that no one but people with pectus could really answer. There were people who had the exact same conditions as me. It felt like doing the surgery would be the right choice. It reaffirmed my choice, for now.

The Actual Surgery

May 15th 2025

I have to say, it is a really weird experience. As the week comes closer, you go through a bunch of movies in your head of what the surgery day will be like. Then, you actually go through it. Driving, waiting room, another waiting room, talking to doctors and nurses, IV, and I do not remember anything until I wake up.

Oh wow, I’m alive. As I was saying, the movies that loop through your head depend on how you think. You could say I am not the most optimistic thinker. But, I am here so all that thinking was for nothing, I guess.

Recovery

For the first week, the recovery was pretty slow. I had to reacclimate to how to do basic things. Brushing teeth, pretty hard. Showering? Tedious. Actually, the first time I tried taking a shower, I had my mom helping me. When someone looked at the incision the wrong way, it did not like that. I started having chills and started having hypothermia-like symptoms. It subsided after putting on clothes and sitting in a blanket. I still do not know why that happened, but it never happened after that.

Roadbumps

May 27th 2025

Fast forward two weeks later, recovery is chugging along. I am feeling a sort of achy feeling in my legs and chills that run down my entire body. From previous encounters with the flu, I knew that my body was signaling to me that fever was coming. That is essentially impending doom for someone who is post-surgery. Furthermore, there was an incision that was looking suspicious. Combining the fact that I was feeling feverish and had chills, the equation equaled no bueno. After some back and forth, my parents and I decided to haul our butts to the emergency room.

It was suspected I had some sort of infection. Yay…I got hospitalized for a second time. This time, it was with IV antibiotics, constant x-rays and blood draws. Those are the physical things. Mentally? Stress, doubt, regret. On the second day I was admitted, it was confirmed I had one liter of liquid in the surrounding space of my lungs. The next day I would need to get the fluid taken out of my lungs under anesthesia. It was also decided that I should get a PICC line in case I would need IV antibiotics for an extended period of time.

The Inevitable

No one can really prepare you for any sort of hospitalization. However, when you pour your heart into a decision, you hope and deep down expect that decision to be good and have positive consequences. When they don’t, you are sad. The third day was exactly that for me. I was doubting the decision to do the surgery. What was the point? Was it needed? I wanted the easy way out, take the bars out. All the hard work that had been done could go in the trash. I crumbled under the stress and regret.

Now you would think there would be a build-up to this moment in my brain? Nope. It was spontaneous. There were infection specialist doctors visiting. Suddenly, I felt a rush of anxiety, an almost panic attack. I broke down crying. I didn’t want the doctors to see my incisions. I wanted the bars out. I did not even want the fluid out of my lungs. I wanted to go straight to the OR and get the bars out. Rational thinking out the window. The entire day was crappy.

Silver Lining, you could say

There is one thing I still to this moment remember and look back on. Each hospital staff member I encountered tried to make me laugh in some silly way, which to this day I still remember and appreciate. I bet this is nothing new to them, but to see that they still care and want to see me at least smile. It gave me hope that I will get better. Furthermore, my surgeon went out of his way to sit down with me 1-on-1 and become a mini therapist. Talk through the feelings I was having. Why this was happening. Why I said yes to this surgery in the first place. A reframing that was much needed.

Conclusion & Reflection

I was hospitalized for five days. After that, I got weekly blood draws and x-rays until around the end of July. I do not have an infection anymore. Even though the hospitalization only lasted five days, mentally, I was depressed and regretful for a solid 4-7 weeks. It made me doubt everything about the surgery. I am writing this at the end of August, right before my second year of college. Currently, I am doing well. I am getting adjusted to the bars, and more importantly, my bars are not complaining about anything so far. I am focusing on getting my new apartment in college set up. I hope this school year goes well, and I start to see some meaningful improvements in my quality of life with this foreign body in my object.

Thank you for reading this blog post. I appreciate it if you made it to the end. If you got the Nuss procedure within the last three months, hang in there! If you don’t even have pectus but were interested in my story, I hope you learned some new things about your body!